High-dose vitamin D supplementation reduces complications in pediatric type 1 diabetes patients: Study
USA: High-dose vitamin D supplementation in children and adolescents with new-onset type 1 diabetes (T1D) may decrease complications, a recent study in Frontiers in Endocrinology has suggested. This, according to the study, has the potential to alter T1D's natural course and reduce the burden of the disease complications.
Recent randomized controlled trials (RCT) have shown that vitamin D could protect the β-cells during the honeymoon phase of T1D. This has led to calls for the guidance of vitamin D supplementation during the critical phase of type 1 diabetes. Prolonging the partial clinical remission (PR) phase of TID betters glycemic control and reduces long-term complications of T1D.
In the randomized trial, the researchers included 36 children and adolescents. They were randomized to receive either vitamin D2 (ergocalciferol, given as 50,000 international units per week for 2 months and then every other week for 10 months) or a placebo.
Based on the study, the researchers found the following:
- Vitamin D significantly decreased the temporal rise in both hemoglobin A1c at a mean rate of changes of 0.14% every 3 months versus 0.46% every 3 months for the placebo group and in the functional marker of PR, the insulin-dose adjusted A1c at a mean rate of change of 0.30% every 3 months versus 0.77% every 3 months for the placebo group.
- The researchers recommend a baseline estimation of 25(OH)D concentration at the time of diagnosis of T1D, and to begin vitamin D supplementation if serum 25(OH)D concentration is <30 ng/mL, to maintain serum 25(OH)D concentrations between 30-60 ng/mL.
- If serum 25(OH)D concentration is >30 ng/mL, monitor vitamin D status with serial 25(OH)D estimations; and initiate vitamin D supplementation if serum 25(OH)D concentrations drop to <30 ng/mL.
The authors conclude, "vitamin D supplementation should be continued for at least one year to ensure optimal benefit from vitamin D supplementation during the partial clinical remission phase of type 1 diabetes."
Reference:
Nwosu BU (2022) Guidance for high-dose vitamin D supplementation for prolonging the honeymoon phase in children and adolescents with new-onset type 1 diabetes. Front. Endocrinol. 13:974196. doi: 10.3389/fendo.2022.974196
